What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior?
Write about them here.. and I will too! ..Maurice (DoktorMo@aol.com)

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Thursday, August 05, 2010

Would You Accept a Gay or Lesbian Physician as Your Doctor?

A question I would like to pose to my blog readers today is about whether patients should request information about their physician’s sexual orientation and decide on the answers as to whether to have this doctor for their own and their family’s care.Would it make any difference to you whether your doctor was gay or lesbian or bisexual, if that doctor appeared and acted in a knowledgeable and humanistic manner and was performing a competent job? Would you accept a gay or lesbian physician as your doctor? Or is a physician’s sexual preference none of the patient’s business? This is a question probably not many patients think of as they acquire or continue care by a physician. Nevertheless, as physician Henry Ng writing in the current August 2010 issue of the AMA’s “Virtual Mentor”

the matter of sexual orientation may come up with an innocent question by the patient, “are you married?”To understand the significance of sexual preference disclosure by the physician and the dilemmas that the doctor faces when challenged with questions by the patient regarding the physician’s personal life, read the article by Dr. Ng, return and write your opinions here. ..Maurice.

25 Comments:

I would. In fact, I don't think there is any need for me (or any patient) to know whether their physician is gay/lesbian. I consider that their personal life.

The relationship between the physician and patient is not want that warrants details of either person's sexuality. Having said that, I don't think means that being gay/lesbian is anything to be ashamed of. Far from it. I just think it is unnecessary to be discussing it within doctor/patient relationship.

Mandy,thanks for your prompt response. Do you think that physicians need the actions of some advocacy group to broadcast to the public the views that you expressed in your response? Again, thanks. ..Maurice.

To be honest, Maurice, I think it is a sad sorry state that physicians need to have an advocacy group to try and stop something that really shouldn't be an issue from being an issue in a doctor/patient relationship.

However, if a society believes it has a fundamental right to know the personal goings on of it's physicians then maybe an advocacy group is what is needed. I consider that a real shame, if that is the case

Without question, I would accept a LGBT physician. Sexual orientation is absolutely irrelevant to the person's competency as a doctor. I honestly don't care about the sexual orientation of my doctor.

In an ideal world, the doctor has no obligation whatsoever to reveal his sexual orientation. We do not live in an ideal world. We live in a world where many women would feel more comfortable with a hetero male ob/gyn than a lesbian female ob/gyn, which makes no sense whatsoever. So, the real world is more complicated. I do think that good advocacy organizations should play a role. Advocacy organizations should focus on educating people that members of the LGBT community are in every strata of society. They are doctors, lawyers, politicians, bank tellers, construction workers, and, yes, military officers. They aren't just abstract figures that march in gay pride parades and try to get married.

As far as who the physician should tell, I do think there might be an obligation to tell any partner doctor in the practice, because, unfortunately, this information may ultimately affect the success of the business. Doctors don't have to tell patients anything, but I agree with the author of the article that it's certainly better for one's psychological health to be open.

There is an interesting dilemma here and I don't think the answer is as straightforward as that article implied. I personally wouldn't care whether my doctor was gay or straight, but if I felt there was a sexual vibe there during a genital exam that would definitely be a turn off. We accept that people have a right to choose physicians of a particular gender for more intimate examinations based on nothing more than the patient's subjective comfort level with that particular gender. We understand, and accept, that a patient may not be comfortable getting naked in front of a doctor if he or she perceives there may be sexual overtones to the encounter, and thus we respect the patient's right to choose the gender they are most comfortable with and request chaperones.

Though in most circumstances, gay people should have the right to privacy and non-disclosure for all the reasons stated in that article, in this particular instance, doesn't the patient have the same right to know whether a doctor is gay and therefore, presumably not "safe" from a standpoint of sexual comfortability on the part of the patient, as they would to choose a particular gender? I can see where if a doctor fails to disclose his or her sexual orientation, and is later outed, a patient who had a genital exam might feel violated for reasons that have nothing to do with homophobia and everything to do with that patient's subjective comfort level.

What physicians do in their time out of the office/lab/OR isn't any concern of mine as long as it has no effect upon their patients. If (s)he is gay or lesbian, it's unlikely to have any direct bearing upon patient care, so the issue shouldn't come up in the first place. Yes, it's interesting at times to know more about your physicians as people, but they are under no obligation to disclose personal information that has no impact on their care of patients.

A visitor to this thread wrote yesterday the following. ..Maurice.I have no problem with the sexual orientation of the physician. At the end of the day, they are sick and tired of seeing and holding body parts of sick people that they couldn't careless about it. I believe that they are also professional in a way since they wouldn't want to lose their license if they take advantage of anyone.

Pam, a word of caution. I hope you are not looking toward any romantic relationship with that lesbian physician while you were her patient since that would be a professional "no-no"! And, in fact, if the relationship was made known, she could lose her license to practice medicine. This relationship would be against the American Medical Association Code of Ethics but also against state professional laws. It has nothing to do with sexual orientation. It is all related to a professional conflict of interest and unequal power between any physician and his or her patient. ..Maurice.

I think a lot of the "don't ask don't tell" posts are missing the point. Individual privacy with regard to orientation is the easy question. But for the sake of discussion...you do find out they're GLBT.

Example--You had a consultation in a physician office and there on his desk is a wedding photo (a pretty common occurrence, I have one on my desk) of him and his partner. That's where the question should really begin.

I'm going to be honest. I know as many gays as straights and support GLBT equality, and I would still be uncomfortable. I simply can't control that reptilian portion of my brain that would take me aback a little. However, I can fully control most of the rest of my brain and I would override the reptilian portion because I know that those thoughts are irrational and unfair and that their kin throughout history have cause a lot of hurt to a lot of people.

I tell this full side of the story because I think it's important for people to understand that whether on sexual orientation or race or anything else...I don't think it makes you a bad person to feel the urge to look away or clutch your purse a little tighter or butch it up. You're not going to be able to control that easily. What you can control are the actions you consciously take, rational decisions. That's how we teach appropriate behaviors to ongoing generations and maybe even change that gut reaction for them.

This discussion reads like it could be a spin-off of the Patient Modesty one. The reason I say this is because there are only certain aspects of the physical examination where it might matter whether your doctor is gay or lesbian. Imagine a situation where a woman arrives for a pap smear, her family doctor is male but she has requested a female doctor to perform the procedure, this reasonable request is granted, and that female doctor "happens" to be lesbian. What now?

I was also a little amused by the title of the thread. I'm in Canada, where you are lucky to have any doctor at all as your family physician.

Dr. V, you write: " has requested a female doctor to perform the procedure, this reasonable request is granted, and that female doctor 'happens' to be lesbian. What now?"

I would say nothing upsetting for the patient happens if the physician behaves professionally and the physician did not inform the patient of the doctor's own sexual preferences. Incidentally, one cannot exclude the possibility that the patient's own sexual preference would be identical to that of her still "un-outed" doctor. ..Maurice.

I think the important consideration is not the doctor's sexual orientation, but her or his openness and inclusiveness towards all patients. I am pleased whenever I encounter a doctor whose medical history forms do not assume heterosexuality.

I'm a hetero and I would accept a gay male doctor or nurse over a female any day. I couldn't make a career out of seeing or touching naked men every day, but when it comes to NECESSARY medical intimate care I don't see anything morally wrong with sticking to my own gender. Whether he's gay or not doesn't matter because I don't see anything that a male medical professional would do to me as being sexual.

As I say to females in healthcare it doesn't matter to me how comfortable you are with my nudity, it's what I feel that counts. I also try to keep in mind that just because a man may be gay it doesn't necessarily mean that he's attracted to me. I'm hetero but that doesn't mean that all hetero women are attracted to me.

How can anybody that preaches "gender neutrality" or anybody that believes in it worry about whether their doctor is gay or not? If men don't think there's anything sexual about a female nurse catheterizing them why would it be sexual for a gay man to do it?

When I chose a physician I prefer one that is knowledgable, emphatic and honest. That treats me with dignity and respect. The thought that every gay/lesbian is attracted to every individual of the same sex is obsurd. Where do you draw the line? What about a straight married doctor that commits adultery? That's a form of dishonesty. Do I want someone who's "character" is a liar, even though they're not lying to me as I am not their spouse, none the less, which is worse a faithful gay partner or an adulterer for a trusted physician?

If the doctors sexual orientation should not be any business of the patient, then should the patients sexual orientation be any business of the doctors? It works both ways. If pyhsicians expect or want their patients to be open about their life, they should in return expect to be open about their own life. Or is it that trust is only a one sided street? If the patient knows, they should have the right to walk away if they want. As far as an advocacy group, what are they going to do, force the patient to see that physician despite their sexual preference? Although that woundn't surprise me to see them try that. MDS

I don't understand the way people differentiate between people or judge them on that which should never be judged.How many sorts of people are there?The issue at the root cause of all prejudice is Judgement and given the we all live in glass houses one way or another - who has the right to judge another.

One's sexual preferance is one's own business.

The greater concern is one of humanity and caring and professionalism in a caring profession surely?

If my Doctor was black white and brindled with orange and told me he was a tranvestite as he stood before me with a moustache in a dress that would be fine if was a caring concerned Humanitarian FIRST.

I have been thinking a great deal about the many facets of this discussion as prompted by the original question and feel I left a few things out...............

Compassion, Understanding andRespect and most of all Awarenessby the giving and the gifted in equal shares.

Awareness is as individual as the individual and entirely dependant upon the upper three in our own Life Experience.Imagine Compassion, Understanding andRespect being accepted first and foremost and then return to one word:Humanity.

"Judge not less thee be Judged" said a rebel 2000 years ago. How about listening to Him even more?He did have a good few things to say........like "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these."

No I do not believe in orthodox religion but I believe in Him and I believe in people.

And I believe in the Love and Peace he talked about - Love of fellow Human Beings and the acceptance of our equal differences.

You want a doctor? If the Doctor is a good person what difference does it make if he/she loves someone you wouldn't?It's the Love and Care that counts.Isn't it?This World needs more good Doctors and a great deal more trust I reckon

I would not care. Like an earlier poster said, this is more complex than it appears.

Here's what I started thinking about. GLBT issues have been so politicized in recent years that the country was whipped into a frenzy. That may well be trumping other things so such a decision becomes one of judgment rather than comfort/preference.

I discriminate based on age. At age 60, I would not be comfortable with a doctor younger than 40. I get to make that decision. I'm not trying to stir up hate against younger doctors. I was once younger than 40 and I know there are some great young doctors. It just wouldn't be my choice.

I don't think the lifestyle of a doctor is any of my business and I would never ask the question. If a patient is uncomfortable with a doctor for any reason, it would be ideal if they could go somewhere they are comfortable.

I am a lesbian G.P. I have acknowledged my sexuality when patients have asked,.I would like to say that when I was young I had to go to a male heterosexual doctor because there weren't any women docs around. it was a very painful experience with a condescending male that made me realize we needed women in medicine it. All women were expected to just accept that doctors were male. I have trained with male doctors who are pigs and can say from experience that people should be concerned with them more than any lesbian doctor who doesn't have to control testosterone and the brain of a penis. Secondly, I have treated gay and straight patients and have only ever been concerned with their health and being the best doctor I could be for them. I have observed through the years that there is a great deal of sexual abuse with so many of the women I have treated ,especially lesbians.. 99 % of the time that abuse was by a male It is also very often heterosexual men who are sex offenders and pedophiles even religious leaders. You should really pick a doctor based on how you connect to them and if you feel like you are being heard , respected and that you can trust their knowledge and care. You must also maintain sexual boundaries with any doctor. If you get any kind of vibes that make you uncomfortable find another doctor. Just my thoughts. DR. Lfowyc5z0

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